San Francisco likes to think of itself as bold and cutting edge, promoting the tough ideas that others are too timid to consider. What a crock.

Cameron Quanbeck, a psychiatrist who works at San Francisco General, estimates that there are about 3,400 severely mentally ill individuals in San Francisco who refuse treatment. But that's no surprise to you. You see them walking the street, holding conversations with imaginary companions and - as I saw a man do Monday morning - walking into traffic and yelling at cars. I defy anyone to say this city has a grip on this problem.

Laura's Law, which provides court-ordered mental health treatment for those individuals, is the kind of bold, breakthrough idea the city was once known to promote.

But today, when it is considered by the Board of Supervisors, it will face an uphill battle. This is San Francisco at its worst, protecting small constituencies, worrying about legal consequences and letting lobbyists carry the agenda. It is an embarrassment for the city that used to know how to take a courageous stand.

Last week, I met with Nick and Amanda Wilcox. Their 19-year-old daughter, Laura, was the inspiration for the law. She was shot four times by Scott Thorpe, a severe paranoid schizophrenic who refused to take his medication. Laura was working as a receptionist at a health clinic during Christmas break from college. She was found with a pen still in her hand.

"If this could happen to my daughter, it could happen to anyone's daughter," said Amanda Wilcox.

Laura's Law has its flaws. Much is made of the fact that Mitch Katz, the city's director of health, does not support the law. But his complaint is that it doesn't go far enough.

"I would definitely support a Laura's Law that allowed a judge to order medication," Katz said.

I wouldn't hold my breath for that legislation. The lobbying against Laura's Law from mental health advocates is fierce.

And as much as we'd like to force mentally ill people to take their medication, that's not right. The days of the "snake pits," when the mentally ill were locked up, drugged and made to endure tactics like shock therapy are gone. And they should be gone.

But that doesn't mean these disturbed individuals should be left to their private hell. Laura's Law provides a structure of treatment, and although it doesn't work every time, the results can be dramatic. Quanbeck, a psychiatrist who works at S.F. General, estimated that if only 15 percent were successfully placed on treatment programs, the savings could run to the millions.

I find it hard to believe that someone like Supervisor John Avalos, the father of a young daughter, can look the Wilcoxes in the eye and tell them that there are already enough services in the city. Or that Avalos, who is strongly opposed to approval, can walk the streets, see ragged people holding conversations with imaginary companions and say that those services are doing enough.